Laser-induced thermoablation of tumours of the head and neck under MR tomographic control

This study evaluates the potential of MR-guided laser-induced thermotherapy for the treatment of recurrent head and neck tumours, as a stand-alone met hod, or in combination with radiotherapy. 15 patients with recurrent head a nd neck tumours (recurrent squamous cell carcinoma n=13, recurrent pleomorp hic adenoma n=2) were treated, using MR-controlled laser-induced thermother apy. 18 lesions were treated with 25 laser applications. MR thermometry was performed, using a temperature-sensitive TurboFLASH (TR/TE/TI = 7/3/400; f lip angle = 8 degrees) and FLASH-2D (TR/TE/flip angle = 102/8/70 degrees) s equence for monitoring thermal-induced changes in signal and morphology. T- 1 weighted (TR/TE=700/15) sequences, plain and contrast-enhanced, were used for follow-up. 14 patients tolerated the procedure well. In one patient, w ith a recurrent squamous cell carcinoma and infiltration of the sublingual gland, the treatment had to be stopped after 5 min due to pain. No long-ter m side effects related to treatment were observed. We were able to induce c oagulative necrosis in all patients. The 4 year MR-control study of one pat ient with a pleomorphic adenoma showed no recurrent tumour. Clinically-rele vant improvement of symptoms was observed in 11 patients. MR-guided LITT is an excellent method of treating a local tumour recurrence in the head and neck region. MR-thermometry allowed monitoring of laser-induced heating dur ing LITT.